Knowledge, attitudes and practices on seasonal influenza vaccination among health care workers in Hong Kong

Abstract

BACKGROUND: Health care workers (HCWs) are exposed to various health risks in their occupational settings, including the risk of contracting many infectious diseases such as influenza. The poor uptake of seasonal influenza vaccination among HCWs is an increasingly common problem encountered by different countries in recent years. A better understanding of the determinants of poor uptake is required to identify newer approaches for improving the uptake of influenza vaccination among local HCWs and yet little is known about their practice and attitude on seasonal influenza vaccination policy offered by the workplace. METHOD: A series of nine rounds of self-administered questionnaire survey were conducted over a period of 19 months (from Oct 2013-May 2015), covering two winter influenza epidemics and two non-epidemic periods, in the Hong Kong West Cluster of Hospitals (HKWC) of the Hospital Authority in Hong Kong to assess workplace productivity loss related to acute respiratory illness. As part of the survey, we included questions about the practice on influenza vaccination and attitude toward difference influenza vaccination policy. RESULTS: Among 585 HCWs surveyed, only 22.9% had received influenza vaccination in the past one year (2014-2015). Only 6.4% of those currently not vaccinated reported an intention to get vaccinated in the future. Common reasons for not getting vaccinated included concerns about vaccine efficacy (31.6%), worry about allergy or other side effects (29.4%), and not considering it is necessary because of their good health (28.7%). Only 22.1% agreed with a potential policy of mandatory influenza vaccination for HCWs. On the other hand, 36.8% considered the giving of an incentive acceptable for improving influenza vaccine uptake among HCWs, with 49.4% considering an incentive of less than HK$500 being an appropriate amount of incentive, while 58.1% consider annual leave an appropriate form of incentive. CONCLUSION: The persistently poor uptake of seasonal influenza vaccination among HCWs in Hong Kong indicates the need to examine other possible options to improve uptake, including the issuance of incentives or mandatory HCW vaccination, and begin to address the associated controversy with these options. Our data also indicated that these alternative approaches are still considered controversial by the majority of local HCWs, signifying the need of better communication to understand their views and concerns on these issues.